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🌱 created from: Prognostic Models of follicular lymphoma

pod24

Progression of Disease within 24 months (POD24) in follicular lymphoma (FL) is a significant prognostic marker indicating poor outcomes for patients. It refers to the progression or relapse of FL within two years following the initiation of first-line therapy. Multiple studies have validated POD24 as a robust indicator of survival, emphasizing its clinical relevance in managing FL.

Importance of POD24

1. Prognostic Significance: POD24 has been identified as a strong predictor of overall survival (OS) in FL patients. Research indicates that those who experience disease progression within 24 months have significantly worse survival rates compared to those who do not. For instance, a pooled analysis of clinical trials revealed that patients with POD24 had a hazard ratio of 4.85 for subsequent OS, indicating a markedly increased risk of poor outcomes[1][5].

2. Clinical Predictors: Factors associated with an increased risk of POD24 include male sex, poor performance status (PS), elevated β2-microglobulin levels, and a high-risk Follicular Lymphoma International Prognostic Index (FLIPI) score. These predictors can help clinicians identify high-risk patients who may require more aggressive management strategies[1][5].

3. Impact of Treatment: The type of initial treatment also influences the prognosis of patients with POD24. Studies have shown that patients treated with rituximab alone tend to have a better prognosis compared to those receiving more intensive chemotherapy regimens like R-CHOP or bendamustine-rituximab (BR). Specifically, the five-year OS for POD24 patients treated with R-CHOP was significantly lower than for those treated with less aggressive regimens[2][3][5].

4. Transformation Risk: There is a notable risk of transformation to aggressive lymphoma in patients with POD24, with studies indicating that approximately 75% of POD24 cases may involve such transformation. This transformation is a critical factor contributing to the poor outcomes associated with POD24[5].

5. Management Strategies: For patients identified as POD24, management strategies may include more intensive therapies or clinical trials exploring novel treatments. The need for individualized care is emphasized, particularly for patients experiencing early progression[4][5].

Conclusion

POD24 serves as a crucial endpoint in the management of follicular lymphoma, guiding treatment decisions and prognostic assessments. Understanding its implications can help improve patient outcomes through tailored therapeutic approaches and early identification of high-risk individuals. Continued research is essential to refine strategies aimed at preventing POD24 and enhancing survival rates for affected patients.

Citations: [1] https://pubmed.ncbi.nlm.nih.gov/34614146/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953041/ [3] https://ashpublications.org/blood/article/142/Supplement%201/6150/505600/Prognosis-of-Progressive-Follicular-Lymphoma [4] https://ascopost.com/video-roundtable/treatment-options-for-relapsed-refractory-follicular-lymphoma-what-comes-next/relapsed-follicular-lymphoma-with-pod-24/ [5] https://ashpublications.org/blood/article/139/11/1609/484335/POD24-in-follicular-lymphoma-time-to-be-wise